Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,068.21 / $1,068.21 / $1,068.21	Facility		$1,068.21	$1,068.21	$1,068.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $617.29 / $1,068.21 / $1,068.21	Professional		$617.29	$1,068.21	$1,068.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,537.48 / $1,537.48 / $1,537.48	Professional		$1,537.48	$1,537.48	$1,537.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $219,999.78 / $539,999.46 / $949,999.05	Facility		$219,999.78	$539,999.46	$949,999.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,659.10 / $2,195.87 / $2,439.85	Professional		$1,659.10	$2,195.87	$2,439.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,441.39 / $1,441.39 / $1,441.39	Facility		$1,441.39	$1,441.39	$1,441.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,441.39 / $1,441.39 / $1,441.39	Professional		$1,441.39	$1,441.39	$1,441.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,200.11 / $1,200.11 / $1,537.48	Facility		$1,200.11	$1,200.11	$1,537.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $876.09 / $1,200.11 / $1,501.45	Professional		$876.09	$1,200.11	$1,501.45
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $1,768.10 / $1,768.10 / $1,768.10	Professional		$1,768.10	$1,768.10	$1,768.10
United Facility/Professional Professional Modifier Low / Median / High Price $479.40 / $950.24 / $1,155.42	Professional		$479.40	$950.24	$1,155.42